Student Admission Set

STUDENT ADMISSION SET

Student Information

Date of Birth:    Student ID (if assigned):

Parent / Guardian Information

Primary Phone:    Email:

Program Enrollment & Financial Agreement

Program Start Date:

Pay in full at time of enrollment
Installment plan (institutional schedule applies)
Third-party sponsorship or scholarship (attach documentation)

Financial Terms: By enrolling, the applicant (and parent/guardian where applicable) accepts financial responsibility for tuition and fees as stated above. Payment is due on scheduled dates; past due balances may result in hold on records, denial of attendance, and referral to collections. Withdrawals are subject to the institution's published refund policy: refunds are calculated based on the date the institution receives written notice of withdrawal and may be prorated. Additional administrative fees may apply.

Academic Policies & Acknowledgments

The applicant acknowledges that admission is contingent upon receipt and verification of requested records and compliance with academic standards. The institution reserves the right to revoke admission if false information is provided or required documentation is not received. Attendance, conduct, and academic progress are governed by institutional policies and codes of conduct which the applicant agrees to follow.

I acknowledge receipt of the institution's policies on attendance, academic integrity, and student conduct and accept responsibility for compliance. I understand that failure to comply may result in disciplinary action including suspension or dismissal.

Medical, Emergency & Consent

Emergency Contact Phone:

Medical Authorization: In the event of an emergency and if the parent/guardian cannot be reached, I authorize the institution to obtain necessary medical care for the student. I understand that I am financially responsible for any medical or ambulance services rendered.

Photo and Media Release: I grant permission for the institution to photograph or record the student for educational and promotional purposes, subject to institutional guidelines. I understand that such media may be used in institutional materials and publications.

Records, Residency & Prior Education

Authorization to Obtain Records: I authorize prior schools to release academic and disciplinary records to this institution for purposes of admission and placement.

Residency Status: Local resident    Non-local resident

Required Documentation Checklist

Please attach the following documents with this admission set. Check each item when attached:

Birth certificate or legal proof of age
Official transcript or prior academic record
Immunization record or exemption documentation
Proof of residency (utility bill, lease, etc.)
Photo identification for parent/guardian (if required)

Certifications & Declarations

Certification of Accuracy: I certify under penalty of law that the information provided in this Student Admission Set is true, complete and correct to the best of my knowledge. I understand that providing false or misleading information is grounds for denial of admission or subsequent disciplinary action, including possible revocation of enrollment.

Consent for School Policies: By signing below, I accept and agree to abide by applicable institutional policies, financial obligations, attendance requirements, and codes of conduct. I authorize the institution to take actions necessary to enforce policies, including but not limited to placement holds, referral for collection, or disciplinary procedures when warranted.

Acknowledgment and Signature

By signing, the undersigned affirms that they are the applicant or the parent/legal guardian of the applicant and have the authority to enroll the student and accept the terms set forth in this document.

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